Chapter 18 – Male Sexual Dysfunction, Prostate Disease and Testicular Lumps
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Erectile function
The penis consists of two spongy erection tissues called corpora cavernosa that extend along the penile shaft and anchor onto the pubic rami (see Figure 18.2). Each corpus has a central cavernosal artery which increases blood flow during an erection and together with associated smooth muscle dilatation in the cavernosal tissues, creates a large pressure against the surrounding tunica albuginea which compresses the draining emissary veins. Thus, the blood flow results in tumescence and the compression of the veins makes the erection rigid. The spongy tissue surrounding the urethra is called the corpus spongiosum and distally becomes the glans penis, which becomes tumescent but not rigid.
Erection is a neurovascular event under hormonal control. It includes arterial dilatation, trabecular smooth muscle relaxation and activation of the corporeal veno-occlusive mechanism.
Normal changes to erectile function occur with ageing and include:
longer time to achieve erection more difficult to sustain erection more tactile stimulation required to gain full erection less intense orgasm reduced ejaculation volume longer refractory period ... Buy now